Individual provider Active NPI

Mitchell Ian Troyer, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Evansville, IN
National Provider Identifier
1518387828
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12012163A Issued in IN
Practice address
550 W Virginia St
Evansville, IN 47710-1684
Phone
(812) 425-5194
Fax
(812) 858-3110
NPI assigned
Apr 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12012163A IN Primary

Addresses

Primary practice location

550 W Virginia St
Evansville, IN 47710-1684

Mailing address

1600 S Andrews Ave
Ft Lauderdale, FL 33316-2510
Phone (954) 355-5703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909002452 IN Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0648509133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Nova Southeastern Univ College of Dental Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oral Surgery Group of Evansville IncGroup PAC ID 5991880106, 5 clinicians

Practice addresses (Care Compare)

550 W Virginia St
Evansville, IN 47710-1614
Phone (812) 425-5194

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Group of Evansville, Inc Oral and Maxillofacial Surgery CurrentSince Jul 27, 2019 Accepting new patients

Locations

550 W Virginia St
Evansville, IN 47710
Phone (812) 425-5194

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1518387828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101684",
            "telephone_number": "812-425-5194",
            "fax_number": "812-858-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROYER",
        "first_name": "MITCHELL",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-25",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12012163A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.